Painful piezogenic pedal papules in patients with Ehlers-Danlos syndrome.

Painful piezogenic pedal papules were observed in 10 of 29 patients with Ehlers-Danlos syndrome. The diagnosis was made by examining each patient while he or she stood with full body weight on the heels and by observing the appearance of the painful papules on the medial, posterior, and lateral aspects of both heels. Biopsy specimens of papules demonstrated a thickened and dense dermis.